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Renee Jayne

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You are here: Home / Enrollment Intake Form

Enrollment Intake Form

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Your Intake Form

Welcome! I'm looking forward to working with you. Take your time with this and be as open and detailed as you can. Here are a few pointers: Try not to worry about what I will think. Don’t judge what comes up for you or edit your thoughts in any way. Nothing is too big or too small to mention - everything applies. It's all part of your life. Some of these questions may not trigger any memories, and that’s fine. Simply note that nothing stands out in that section. This is important work. Be as honest with yourself as possible to help the breakthrough process. It is not necessary to write long stories, feel free to share time lines or outline “bullet point” style. As always, everything you share is 100% confidential.
  • As we begin, it is useful to be sure we are aligned in our understanding of the nature of our coaching relationship. Please check below to indicate you agree:
  • (optional)
  • FILE SHARE

  • Feel free to share your most recent blood work or anything pertinent to the work we are doing together.
    Drop files here or
    Max. file size: 256 MB.
    • GOALS

    • YOUR HEALTH STATS

    • HEALTH CONCERNS

    • PREVENTATIVE HEALTH QUESTIONS

    • Your responses will be sent directly to Renee so she can review before your session. A copy will also be sent to your email. Double check your spam folder if you don't see it. If you have any questions, please email support@reneeheigel.com

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